The increase in non-invasive procedures administered by facial plastic surgeons was seen across the spectrum of treatments with the greatest increase being Sculptra, poly-l-lactic acid, (up 71 percent). Other increases include chemical peels (up 52 percent), hyaluronic acid (up 48%) and BOTOX® (up 45 percent).

The survey also showed that 77 percent of physicians agree that patients are more educated about plastic surgery options. With more people wanting to look younger, feel better and take an active role in their health, patients are researching different physicians and treatments to find the best one suited to meet their personal needs. Awareness of various procedures, appropriate physicians, best results and recovery times play an important role in the decision-making process.

“We are excited to see patients making educated choices. They are now open to newer, novel treatments and are making smart decisions that are tailored to their needs,” said Daniel Rousso, MD, President of the AAFPRS. “The overall rise in these procedures also shows that more patients are trusting their face to facial plastic surgeons who are trained and focus solely on the face and neck. Because of this, patients are seeing better outcomes.”

In 2009, women continued to be the most likely candidates for facial plastic surgery making up 84 percent of all surgical and non-surgical procedures. However, men and women are equally split when it comes to reconstructive procedures.

Surgical Procedures

In 2000, facial plastic surgeons reported the facelift as the most common cosmetic surgical procedure, followed by blepharoplasty (eyelid surgery), rhinoplasty (nose surgeries) and ablative skin resurfacing. These procedures are most commonly performed on patients between the ages of 35 and 60 years of age. For female patients under age 35, the most common procedure performed was rhinoplasty.

The surgical procedures with the largest increases over the past year were ablative skin resurfacing (up 57 percent), revision surgery (up 18 percent) and facelifts (up 14 percent). Decreases were seen in lip augmentation (down 52 percent) and rhinoplasty (down 13 percent).

Medispa Findings

Physicians continue to express concern over procedures performed at medical spas (medispas). 76 percent of facial plastic surgeons surveyed say they are aware that medical directors of medispas are not actually on site for medical treatments. Most cosmetic procedures are performed in a private office (54 percent) setting. Procedures performed in a hospital came in at 23 percent and the number of procedures performed at medical spas or medispas remained unchanged (2 percent). Half of the physicians surveyed are aware of misleading advertising involving injectables, lasers and other cosmetic therapies. 35 percent of physicians believe medispas will become a more popular location for patients undergoing treatments.

Other Facial Plastic Surgery Trends

The facelift is the most common procedure performed on Caucasian patients, African Americans and Hispanics are most likely to have rhinoplasty while Asian Americans get blepharoplasty most often. Overall, 80 percent of AAFPRS members who participated in the survey feel that the future holds more cosmetic surgery for ethnic populations.

In addition, more facial plastic surgeons will offer wellness and lifestyle techniques to enhance the patient experience and to provide a more comprehensive approach.

FUZION takes the guess-work out of finding a qualified expert who understands your needs. Consultations are always complimentary and include a full overview of your concerns and a variety of treatment options. Please let us help you find your beauty.

1. What age is the “right age” to begin aesthetic procedures?
We at FUZION opt to reserve the right to refuse treatment to any person who is not physically or emotionally mature. It is not necessarily about a specific age, but it is preferred to operate on legally consenting patients who are physically mature. If a professional chooses to operate/perform an aesthetic procedure on a minor they must consider how that procedure will impact growth or future physical outcome. We have already established in previous blogs that there are plenty of teenagers who have moderate facial wrinkles. This is caused by excessive photodamage (tanning) or pure genetics. The most popular adolescent cosmetic surgery is rhinoplasty (“nosejob”), now I ask you, would you make your child suffer the taunting of other kids until they are 18?

2. Is the patient in front of you psychologically sound to undergo the proposed procedure(s)?
Each Board Certified Plastic Surgeon/ medical professional (like me, I’m a Certified Physician Assistant) is fully trained in psychologic evaluation. It is important to seek out medical professionals for your aesthetic procedure. During a consultation each patient is physically and psychologically evaluated. We screen for conditions including body dysmorphic disorder, anorexia, psychotic illness, histrionic or other personality disorders. If a prospective patient displays signs of these, or a number of other diseases, they will be referred to a mental health professional. Dr. Goodkind and I have many professional relationships with excellent mental health providers. It is never to be taken as a sign of disrespect if you are referred, it just means that we are concerned enough to take care of you. Remember, “DO NO HARM!”

3. Is the patient aware of the risks?
The risks of ALL procedures are thoroughly discussed as part of the informed consent process. If the patient doesn’t verbally express understanding the plan is thwarted. It is a huge responsibility, and a goal of ours at FUZION, to make sure that you, as the patient, are fully educated and understand all aspects of each procedure.

4. Do the desired effects outweigh the risk?
Example: if a patient asks for extraordinarily large breast implants, but we know that they will be too large for her small frame then she will be risking infection, delayed healing, increased risk of rupture, chronic pain and muscle imbalance of her chest wall. These risks outweigh the benefits and therefore would not be appropriate. We don’t like to trade one problem for another.

5. What are the longterm implications of these procedures?
We need to evaluate what these procedures mean for a patient’s future – example: when silicone  is injected into someone’s face it is permanent. As that person ages, the silicone may not appear natural – it does not age as they do and therefore makes them look unnatural. We see plenty of examples of this in Hollywood, New York and Miami. It may be a desirable look to start, but it may not end up that way.

6. What is the patient’s motivation?
During the consultation a patient’s motivation must be clearly established. Why are they seeking surgical or aesthetic procedures? Are they doing it for someone else?  To save a relationship? To “cure” depression?  These are all examples of poor motivation and would be deemed inappropriate candidates for surgery.

7. What are the patient’s expectations and are they realistic?
To achieve a natural look and excellent results, one must have realistic expectations. Aesthetics is ALL ABOUT setting realistic expectations. I encounter this everyday. Dermal fillers, in the right hands, can provide amazing non-surgical results, but the results are subtle and certainly NOT surgical results. It is about technique, skill of the injector, choosing the appropriate product and of course the right patient. I often times have to disappoint people by telling them that they are more apporpriate surgical candidates than filler candidates. This is a perfect example of why people look unnatural: the wrong amount of the wrong product in the wrong patient… (Mickey Rourke, Meg Ryan, “Cat Lady“)

8. When is enough enough?
If your Aesthetic Professional tells you that you need to lay off procedures, or that the procedure will give you an unnatural appearance you need to stop! Or seek mental health assistance if you have become obsessive. No professional should risk their reputation, and future in the field for one bad outcome that could have been avoided. This is the sole reason that I refuse to give people “DUCK LIPS!” Subtle is always more attractive and believeable. You want to be yourself, just more detailed.

Who is to say that Heidi went too far?  Her surgeon was a Professional Board Certified Plastic Surgeon, who has a stellar reputation (Dr. Frank Ryan). She thought about the procedures for three years prior to going ahead with them. Dr. Ryan performed multiple consultations about her procedures and states that she thoroughly and repeatedly expressed understanding her risks. Just because we may not agree with her decision to seek a significantly more mature, and augmented appearance does not mean that it was unethical on the part of the practitioner. All in all, on a professional level his work was impressively done – much more natural than some other examples. We must consider that if Ms. Montag had chosen to have one procedure at a time we would think nothing of this, but since she had multiple minor procedures (fat transfers and BOTOX) at the same time she had multiple surgeries it has been  sensationalized in the media. Don’t forget who we are talking about, “reality star”, Playboy model (to come), aspiring singer and 1/2 of the ”Speidi” duo… It all has to be taken with a grain of salt – a very big grain of salt.

Tell me what you think! I would love to hear what you have to say about all of this.

-Kati

Please join us in opposing the tax for the following reasons:

1. The tax is punitive and places an additional burden on the middle class – According to the American Society of Plastic Surgeons, sixty percent of patients considering a cosmetic medical procedure are squarely in the middle class, earning between $30,000 and $90,000 per year. This tax would come on top of increased payroll and income taxes sure to result from health reform’s $849 billion cost, and would penalize those who have made a well-educated and informed decision in consultation with a specialized physician to opt for cosmetic medical treatments because they allow them to express their best self and have been scientifically tested.

2. The tax discriminates predominantly against women – Medical society data shows that 91 percent of patients seeking cosmetic medical procedures are women. And many of these women are seeking treatment to improve their appearance to enhance their self-image and self-confidence which helps them succeed at work and in other areas of their lives.

3. The tax does not serve the goals of health reform – President Obama has stated that the goal of health reform is “to enact legislation that offers stability and security to those who have insurance and affordable coverage to those who don’t, and that lowers costs for families, businesses and governments across the country.” Since these procedures are generally not covered by insurance, the proposed tax will not reduce the cost of health care nor will it reduce insurance premiums. Further, it will increase administrative costs for physician offices.

4. The tax puts cosmetic procedures in the same category as cigarettes and alcohol – So called “sin taxes” on cigarettes and alcohol were imposed to try to change unhealthy behavior and cover the significant costs that these products placed on the health care system. This is logical. But a tax on cosmetic procedures is illogical because they are healthy and merely a responsible form of self-improvement. Furthermore, these procedures do not impact the heath care system since patients pay for these procedures themselves and they are not covered by insurance. People should have the freedom to decide what is best for their personal health care, including our own aesthetic appearance and therefore be free to spend our own, hard-earned money to correct, alter or enhance our appearance responsibly, in consultation with a physician, without being forced to pay an extra tax.

5. The tax will be impossible to effectively and equitably administer – It is not clear which procedures will be subject to the tax and which will not. Further, the same procedure performed on two different patients could lead to different conclusions concerning application of the tax.

6. The tax discourages innovation and promotes dangerous and unregulated alternatives – Because only drugs and procedures regulated and approved by the Food and Drug Administration (FDA) will be subject to the tax, manufacturers may choose to circumvent FDA regulation to avoid the tax. Further, patients may seek untested and potentially dangerous treatments from unlicensed practitioners to avoid the tax, including seeking treatment across our borders and overseas.

WHAT CAN YOU DO?
• Visit stopcosmetictax.org where you can write to your local Senators or Representatives and sign a petition against the tax.

• The U.S. Capitol switchboard is 202-225-3121 where your patients can be connected to their Senators and Representatives. NOTE: The patient must know the name of their Senator prior to calling the switchboard; this information can be found at www.senate.gov (scroll by state). They can determine the name of their representative by going to www.house.gov where they can enter their zip code.